Androgens in men are derived from the testes and adrenal glands, and in women from the ovaries and adrenal glands. The adrenal glands are located behind the body’s peritoneum, above the two kidneys, and they secrete androgens when the body is tense, irritable and anxious. Estrogen promotes skin metabolism and blood circulation, making the skin delicate and shiny, and inhibits the secretion of sebaceous glands and reduces pores. Androgens, on the contrary, stimulate the enlargement of sebaceous glands, increase sebum secretion, and keratinize hair follicle sebaceous gland ducts. On the one hand, androgens promote sebum secretion, and on the other hand, they block the keratinization of the hair follicle opening, resulting in poor sebum excretion, resulting in large amounts of sebum retention and acne. The retained sebum becomes the best medium for P. acnes bacteria, which rapidly multiply and secrete a large amount of lipolytic enzymes to break down the triglycerides in sebum, leading to an increase in free fatty acids, which in turn can stimulate the hair follicle sebaceous glands to cause inflammatory reactions, forming pus scars and red “bumps”, or in severe cases, cysts. As can be seen above, increased levels of androgens are the physiological basis for the development of acne. However, there are many patients with normal serum androgen levels who still have acne, or even severe cystic acne. This suggests that there must be other factors in the body. The results of the study found that in many acne patients, the elevated serum testosterone levels were not obvious, but in the tissues of their skin lesions, the metabolic intermediate product dihydrotestosterone was significantly higher than in normal controls. . There are androgen receptors and estrogen receptors in human cells, and the sensitivity of their receptors also plays a role in the development and progression of acne. An imbalance in the ratio between androgen receptors and estrogen receptors, and increased sensitivity of androgen receptors to normal serum levels of androgens may lead to the development of acne. Therefore, clinically, an increase in androgen levels, an imbalance in the ratio of androgens (a relative increase in androgen levels and a relative decrease in estrogen levels), and an increase in androgen receptor sensitivity are the initiating factors for the development of acne.